Agenda item

To approve the Director of Adult Social Care and the Director of Finance to implement the proposed Direct Payments Policy and ensure it is embedded in future practice by all relevant staff members.

Agreed that the Director of Adult Social Care and the Director of Finance be authorised to implement the proposed Direct Payments Policy and ensure it is embedded in future practice by all relevant staff members.

Approval was sought to authorise the Director of Adult Social Care and the Director of Finance to implement the proposed Direct Payments Policy and ensure it is embedded in future practice by all relevant staff members.

On behalf of the Chair of the Health and Adult Social Care Scrutiny Board, the Chair of the Economy, Skills, Transport and Environment Scrutiny Board asked for clarification on the result of the commissioned work regarding the Care Act 2014.

The Deputy Leader and Cabinet Member for Finance and Resources identified that the following key areas were in need of improvement:-

•  A requirement for care and support planning to ensure DPs were promoted but with suitable safeguards and checks

•  Strengthen Care Act practice by testing people’s capacity & suitability to manage a DP

•  Clarifying rules regarding using DPs to pay for services delivered by Close Family Members

•  Ensuring clear guidance to clients about their and the Council’s respective responsibilities around the use of DPs, particularly when they are employing staff

•  Strengthening safeguarding aspects by setting out clear roles and expectations for social care and DP workers regarding reviews of the DP package and the financial audit of the DP’s use

•  Improvements in financial audit process to identify key issues quicker so that attention could focus on the clients who appear to have issues in managing their DP

•  Clarifying social care and DP workers’ responsibilities to suspend or terminate DPs in cases of clear misuse, and social care workers’ responsibilities to promptly review the case in terms of safeguarding and to arrange alternative care as appropriate

Clarification from external solicitors was sought on two of the Care Act issues; the Council’s rights to expect DBS checks on people involved in a person’s DP, and the use of Close Family Members. This had been used to set out Care Act-compliant policy.

The outcome was the creation of the policy which sets out proposed policies on these key areas. Revised practice guidance reinforced by training and development would ensure it was delivered.

Questions were also asked on how the Council could support people receiving direct payment of the risk of abuse.

It was explained that this consideration starts during the initial process, where social care workers must check that the person had the capacity to make the decision about whether they want a DP, and whether they had the capability to manage it. If the person did not have capacity, then they would not have a DP unless there was an authorised person to manage it, who must have capacity to do so and who would act in the client’s best interest

During the operation of the DP, it was the social care workers’ regular reviews of the care package and the DP workers’ regular financial audits of the use of the DP that were the key tool in ensuing that the person is buying the care required to meet their assessed needs and that the DP is being used appropriately in line with their care and support plan.

Further questions regarding the right to decline direct payments were asked on behalf of the Vice Chair of Economy Skills Transport and Environment Scrutiny Board. It was highlighted that national literature implies that having a DP was a right. The new policy clarified that it is subject to Care Act conditions regarding capacity and suitability. Paying an external service to manage a DP on behalf of someone was not a compliant solution – if the person could not manage a DP then they are not suitable to be given one and should have a commissioned service instead.

Clients were not obliged to take a DP and could access a commissioned service instead.

In response to questions seeking clarification on whether direct payments could be used for anything other than care, it was confirmed that the services that a DP could be used for were set out in the Care Act. Provided it is a valid and legal service or activity that met the assessed needs, anything in the care and support plan could be delivered by a DP, apart from permanent residential/nursing care and also services delivered directly by the Council. The only real restrictions is that the services must not be ones that were “everyday living” or a lifestyle choice.

A final question was put forward regarding the limitations of Direct Payments for Sandwell citizens assessed as in need of care and support.

It was the potential freedom of a DP that could be a limitation. Having a DP encouraged people to take ownership of their care and support planning and be free to choose how their needs were met. However, as these was public funds, it was stressed that users needed to be aware of the responsibility that went with it, particularly if they had capacity issues and were relying on a friend or family member to support them and to act in their best interests.

Reason for Decision

The Director of Adult Social Care and the Director of Finance had commissioned work to check the compliance of the Council’s Direct Payments practice against the Care Act 2014.

Alternative Options Considered

The Council should have a Direct Payments Policy to cover areas of discretion, or to clarify decisions where issues had arisen in the past.

It could be possible to carry on without a policy, but this risked the Council being challenged on areas where the Care Act does not set out a clear framework, and it was considered prudent, therefore, to ensure that people understand what Sandwell’s policy was.

Agreed that the Director of Adult Social Care and the Director of Finance be authorised to implement the proposed Direct Payments Policy and ensure it is embedded in future practice by all relevant staff members.